高齢者の慢性原発性不眠症の治療のための認知行動療法対ゾピクロン:ランダム化制御試験
Børge Sivertsen1, Siri Omvik, Ståle Pallesen
1Department of Clinical Psychology, University of Bergen, Bergen, Norway. borge.sivertsen@psykp.uib.no
JAMA
|June 29, 2006
まとめ
認知行動療法 (CBT) は,ゾピクロンと比較して,慢性的な不眠症の高齢者の睡眠効率を大幅に改善し,夜間目覚めを減少させた. CBTは,この集団における不眠症の優れた短期的および長期的な管理を提供します.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- スリープ・メディシン (睡眠医学)
- 臨床心理学の臨床心理学について
背景:
- 不眠症は高齢者に多く見られ,健康と社会に悪影響を及ぼします.
- 既存の治療法は,盲検・プラセボ対照試験で直接比較できない.
- 慢性原発性不眠症は,高齢者の有意な部分に影響する.
研究 の 目的:
- 高齢者の慢性原発性不眠症の薬理学的治療に対する認知行動療法 (CBT) の短期および長期の有効性を比較する.
- 客観的および主観的な睡眠測定を用いて臨床的有効性を評価する.
主な方法:
- 46人の成人 (平均年齢60.8歳) が慢性原発性不眠症を患っていたランダム化,ダブルブラインド,プラセボ対照試験です.
- 介入には,CBT (n=18),ゾピクロン (n=16) またはプラセボ (n=12) を6週間,アクティブ治療の6ヶ月のフォローアップを含む.
- 睡眠効率,総覚醒時間,総睡眠時間,スローウェーブ睡眠は,ポリソムノグラフィと睡眠日記を使って評価されました.
主要な成果:
- 認知行動療法 (Cognitive Behavioral Therapy,CBT) は,4つの指標のうち3つの指標でゾピクロンと比較して,短期および長期的に優れた結果を示した.
- ゾピクロンは,ほとんどのアウトカムにおいてプラセボと有意な差異を示さなかった.
- CBTは,ゾピクロンとプラセボと比較して,睡眠効率 (81.4%から90.1%) を大幅に改善し,スローウェーブ睡眠を増加させた.
結論:
- 認知行動療法 (CBT) の介入は,高齢者の不眠症の短期的および長期的な管理において,ゾピクロンよりも効果的です.
- CBTは,睡眠の質とアーキテクチャの持続的な改善につながります.
- 研究結果は,高齢者における慢性不眠症の主要な治療法としてCBTをサポートしています.
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